Impact. Scale. Sustainability. As public health professionals, we are dedicated to high-impact and high-coverage interventions that significantly improve the health of large human populations. We also hope that the benefits become part of the timeless fabric of their families, communities, and the health system.

This triple expectation—impact, scale, and sustainability—has accompanied global health for decades and especially during the last generation. In 1990, Dr. Thomas Bossert reported that, among five US government-funded health programs in Africa and Central America, a project’s capacity to show results was the most important factor to ensure the sustainability of its benefits.

Have you ever wondered what happens after a project activity ends? We are always deeply committed to local ownership and sustainability, yet, we rarely have the opportunity to do long term follow up or reflection. I recently had the extraordinary opportunity to discover for myself the long term impact of the Leadership Development Program (LDP) in Nepal.

The Afghan health system was in shambles after the Taliban government was chased from power in December 2001. Immunization rates had fallen below 20 percent and nine out of ten women were on their own for labor and delivery. Suhaila Seddiqi, newly appointed as public health minister, could have begun her tenure with highly visible and politically popular moves like building hospitals in the major cities. She didn’t. Instead, she led the development of a basic package of essential primary care services and coordinated its delivery to Afghans throughout the country, including remote rural areas. It worked. By 2010, twice as many Afghans had access to family planning, maternal deaths were down by two thirds, and reductions in child mortality had saved 150,000 lives.

Each year, as many as 64,000 people die from tuberculosis (TB) in Indonesia. Although the Ministry of Health’s (MOH) National TB Program (NTP) has made great progress over the last few years, the country is still one of twenty-two high TB-burden countries in the world. Indonesia is also one of the twenty-seven countries considered to have a high burden of multi-drug resistant TB (MDR-TB). In 2011, the nation reported 6,100 cases of MDR-TB.

Donor funding has been a major factor in the success of Indonesia’s TB program over the last few years, especially The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) grants. Indonesia has, however, progressed economically and is now a relatively low priority for Global Fund grants, which are expected to end or reduce significantly by 2015.

Despite Indonesia’s economic growth, the sustainability of the TB program will be a major challenge without support from this critical donor, especially during the funding transition period.

Building local capacity is a pillar of the United States Agency for International Development's USAID Forward reforms. This post is one example of how USAID worked through Management Sciences for Health (MSH) to build, nurture, and support a local development stakeholder that is still thriving today. The story was written by global health writer John Donnelly, and first appeared in MSH’s book Go to the People in 2011.Cross-posted on Modernize Aid in the Modernizing Foreign Assistance Network (MFAN) blog field feedback series.

The prospect that we may see the end of AIDS in our lifetime has never been greater. Over the last decade, the global HIV & AIDS community has achieved stunning successes, including a steady decrease in new HIV cases, a massive scale-up of antiretroviral therapy (ART), and proof that treatment is prevention. As we begin the XIX International AIDS Conference, we are also excited by new scientific advances in prevention and treatment, such as Option B+ for prevention of maternal-to-child transmission (PMTCT). As new possibilities develop, we must also build on the successes of the last decade. Only by "turning the tide together" through the simultaneous pursuit of new possibilities, leveraging of proven interventions for scale and sustainability, and strengthening of health systems overall, can we hope to reach our goal of ending the HIV & AIDS epidemic.

Over 100 conference delegates came together at the United Nations Conference on Sustainable Development last week in Rio de Janeiro, Brazil, to strategize smart solutions to global development and poverty reduction while promoting environmental concerns such as clean energy, sustainability, and equitable use of resources. Popularly known as “Rio+20” --- for occurring twenty years after the 1992 Earth Summit --- the three days of high-level meetings attended by heads of state and government and high level representatives resulted in “The Future We Want,” a 53-page document that outlines and renews global commitments to sustainable, earth-friendly development.

To support the efforts of countries that have committed to making substantive universal health coverage reforms, experts in many areas of financial protection must continually share in dialogue and debate.

To this end, the Results for Development Institute, in partnership with the Rockefeller Foundation, is pleased to announce the launch of UHC Forward, a new website that tracks and consolidates key health coverage information from hundreds of sources into a one-stop portal with feature news, events, and publications related to the growing global universal health coverage (UHC) movement.

How did Malawi control its brain drain?

The British Medical Journal issued a report last month estimating that nine African countries have lost $2 billion worth of investment in training and educating doctors who have subsequently migrated abroad. It needn't be this way. Doctors, nurses and other health professionals do not have to give up home, family and country to earn enough money to give themselves and their children a future, even a modest one. And it needn't cost low income countries billions of dollars to train the doctors and nurses who then leave for greener pastures.

The Program to Build Leadership and Accountability in Nigeria's Health System (PLAN-Health) -- led by Management Sciences for Health (MSH) in conjunction with eight local and international partners -- helped the Nigerian National TB and Leprosy Control Program (NTBLCP) in carry out a capacity assessment. PLAN-Health and NTBLCP defined critical gaps in the program and developed a comprehensive plan to ensure effective tuberculosis (TB) control throughout the Nigeria -- which carries the fourth-largest TB burden in the world.